Department of Radiology, University of Washington School of Medicine, Seattle, Washington; Seattle Cancer Care Alliance, Seattle, Washington.
J Am Coll Radiol. 2013 Nov;10(11):854-8. doi: 10.1016/j.jacr.2013.03.012. Epub 2013 May 25.
The ACR Education Center's Breast MR With Guided Biopsy course is designed to provide radiologists with an intensive, hands-on experience in interpreting breast MR. The aim of this study was to describe radiologists' performance in breast MR interpretation by case clinical indication, lesion type, and BI-RADS(®) assessment to inform future educational efforts.
Data from 16 consecutive courses held from 2009 to 2012 at the ACR Education Center were analyzed. For each MR case, the clinical indication (screening vs diagnostic), background parenchymal enhancement, and lesion type (mass vs nonmass enhancement) were recorded. Participant case BI-RADS assessments were categorized as either correct or incorrect in relation to expert-opinion BI-RADS assessments. Participants' interpretive accuracy on the basis of study indication, lesion type, and background parenchymal enhancement is reported.
Data from 745 course participants over 3 years were analyzed. Of the 96 MR cases included in the analysis, 58% (n = 50) were indicated for screening and 42% (n = 46) for diagnostic purposes. Participants provided correct BI-RADS assessments for 79% of screening cases (32,399 of 41,249) and 74% of diagnostic cases (20,888 of 28,106). Participants more accurately assessed screening compared with diagnostic MR cases (P < .0001) and masses compared with nonmass enhancement (P < .0001). There was no statistically significant difference in performance on the basis of background parenchymal enhancement.
Practicing radiologists perform more accurately on screening compared with diagnostic MR and when evaluating masses as opposed to areas of nonmass enhancement. Future case-based breast MR education efforts should emphasize strategies for interpreting diagnostic breast MR cases and evaluating nonmass enhancement.
ACR 教育中心的乳腺磁共振引导活检课程旨在为放射科医生提供乳腺磁共振解读的强化实践经验。本研究旨在通过病例临床指征、病变类型和 BI-RADS（®）评估来描述放射科医生在乳腺磁共振解读中的表现，为未来的教育工作提供信息。
对 2009 年至 2012 年在 ACR 教育中心举办的 16 期连续课程的数据进行了分析。对于每个磁共振病例，记录了临床指征（筛查与诊断）、背景实质增强以及病变类型（肿块与非肿块强化）。根据专家意见 BI-RADS 评估，将参与者的病例 BI-RADS 评估归类为正确或错误。报告了根据研究指征、病变类型和背景实质增强，参与者的解读准确性。
3 年来，对 745 名课程参与者的数据进行了分析。在纳入分析的 96 个磁共振病例中，58%（n=50）为筛查指征，42%（n=46）为诊断目的。参与者对 79%的筛查病例（41,249 例中的 32,399 例）和 74%的诊断病例（28,106 例中的 20,888 例）提供了正确的 BI-RADS 评估。与诊断性磁共振病例相比，参与者更准确地评估了筛查病例（P<.0001），也更准确地评估了肿块病例而非非肿块强化病例（P<.0001）。基于背景实质增强，表现上没有统计学上的显著差异。
实践放射科医生在筛查性磁共振与诊断性磁共振、在评估肿块与非肿块强化时的表现更准确。未来基于病例的乳腺磁共振教育工作应强调解读诊断性乳腺磁共振病例和评估非肿块强化的策略。
